Why I’m not confident about the state indemnity scheme

When it was announced that the Government was looking at a real solution to disastrous rising indemnity costs, there was a real feeling of positivity.

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But, I’ll be honest, the more I think about the unanswered questions with just over two months to go before its implementation, the less positive I feel.

We still need to know:

1. How will it be funded? The big question. We know that the BMA GP Committee and NHS England are in a stalemate about this. NHS England wants the funding to come out of the global sum, while the GPC wants it to be on top of existing funding. If NHS England win this battle, it renders it pretty much pointless. My interview with Matt Hancock provides little reassurance here.

2. Will it include run-off cover? You would hope that this is a given, considering run-off cover is what enables the medical defence organisations to charge the fees they do. But this has not yet been guaranteed.

Either way, there will be losers. The Government may relent – meaning members of the other indemnity schemes have every right to feel short changed – or it sticks to its guns, meaning MDU members will have to continue taking out an extra policy for future years. It has the potential to be a flashpoint.

4. What exactly will the state scheme cover? We don’t believe it will cover other practice staff, and there have been suggestions that it won’t cover things like fitness-to-practise hearings. So GPs are still unsure about what private cover they will need to take out.

The indications so far are that the Government wants to get away with the minimum on all these points. Mr Hancock’s comments – and the contention in the long-term plan that the scheme will be ‘cost neutral’ – suggest as much.

In which case, it bodes poorly not just for the scheme itself, but for the whole approach to general practice. Because if health bosses are not willing to invest part of that £4.5bn a year into this - a sensible idea that would immediately get GPs on side - then I fear what they will expect GPs to do to receive any funding.

Jaimie Kaffash is Editor of Pulse. You can follow him on Twitter @jkaffash

Readers' comments (15)

YES...THEY ARE MAD.
TRUST ME IN APRIL THERE WILL BE ALOT OF GPs GOING AND THE ONLY THING THAT THEY LISTEN TO IS HARD NUMBERS.
THERE NEED TO BE MASS CLOSURES AND I MEAN MASS CHAOS BECAUSE UNTIL VERY LARGE NUMBERS OF GPs LEAVE NOTHING WILL CHANGE.

Everyone who claims to represent us eg BMA, RCGP etc have had us holding on again and again to give time for promised things to arrive
This is something that would make a huge difference to us and doesn’t require magically finding unavailable staff and it doesn’t look like it will appear as we expected
The fall out from this will be huge: sometimes it is the unexpected things that trigger the biggest change

I have been saying for months that I am less than positive about this; it seems obvious that funding it properly would cost too much for our paymasters. I am pretty stunned at all the GPs who have ridden off on the unicorn offered by the MDU.

But it's not the 'Unicorns' or 'Magic Pixies' promised by 'Machiavellian PPEs' that has occasioned the demise of the medical profession. It's been the total inability of said profession to function as a united and coherent political/corporate body? Pragmatic politicians have RIGHTLY judged us as a leaderless cadre of faint-hearted, chaotic intellectuals (i.e. a community of 'savants') who are incapable of marshalling or accepting any form of leadership.
So we continue to 'Ride off alone into the Sunset'.
Unfortunately!

There is the strong whiff of expectation lowering going on here. NHSE sowing doubts that this will be a whitewash, that we will all be no better off than before, then cheer us up with an indemnity deal that is marginally better than now expected, but nothing like as all singing/all dancing as promised by Hunt in 2017.